Four clients are seated at a table when the nurse brings in medications for one client.
The nurse will determine identity by:

Choice A rationale

The charge nurse, by virtue of their leadership role and oversight of unit operations, is typically authorized to ensure patient safety and continuity of care. This includes re-verifying and administering medications in urgent situations when the preparing nurse is unavailable, adhering to established protocols and double-checking the medication before administration to prevent errors.

Choice B rationale

Limiting medication administration solely to the preparing nurse could delay critical treatment, especially during emergencies. While optimal, this practice is superseded by the need for timely patient care and adherence to a "second nurse check" policy, which enhances safety by having an additional qualified professional verify the medication.

Choice C rationale

Any licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN) on the unit, if familiar with the patient and their condition, possesses the scope of practice and clinical competency to administer medications. This ensures patient safety through appropriate verification, patient identification, and adherence to the "rights" of medication administration, maintaining continuity of care.

Choice D rationale

Pharmacy technicians are not licensed healthcare professionals authorized to administer medications directly to patients. Their scope of practice is limited to preparing, packaging, and distributing medications under the supervision of a licensed pharmacist, lacking the clinical assessment and administration privileges of nursing staff.

Choice A rationale

Comparison is a broad principle of assessment, but "side-to-side" describes the specific methodical approach for auscultation. While comparison is the underlying goal, the physical act involves moving systematically between corresponding areas. Relying solely on a general comparison without a structured sequence can lead to omissions in assessment.

Choice B rationale

Progressing from anterior to posterior in one continuous sweep can lead to missed areas and a less systematic comparison of lung fields. Effective auscultation necessitates a structured approach that allows for direct comparison of symmetric areas, ensuring that subtle differences in breath sounds or adventitious sounds between sides are accurately identified.

Choice C rationale

The side-to-side method facilitates direct comparison of breath sounds between symmetrical lung fields, which is crucial for identifying unilateral abnormalities. This systematic approach ensures that each segment of the lung is assessed in relation to its contralateral counterpart, allowing for prompt detection of differences in air entry, quality, or presence of adventitious sounds.

Choice D rationale

While auscultating interspace by interspace is part of the technique, the overarching method for comparing sounds and ensuring comprehensive coverage is the side-to-side progression. Auscultating individual interspaces sequentially without direct contralateral comparison reduces the ability to identify subtle unilateral changes in lung sounds effectively.

Choice E rationale

A top-to-bottom approach, without consistent side-to-side comparison, can lead to inefficiencies and potential oversight of localized abnormalities. While auscultation generally proceeds superiorly to inferiorly, the critical aspect is the bilateral comparison at each corresponding level to detect subtle variations in breath sounds and identify pathology accurately.